SWATI SHAH DATTA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047429

License Status

CANCELLED

Business

First Name

SWATI

Middle

SHAH

Last Name

DATTA

Suffix

Business Name

SWATI SHAH DATTA DO

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006